Laparoendoscopic single-site retroperitoneal lumbar sympathectomy: initial report

Area of Science:

• Minimally invasive surgery
• Surgical techniques
• Urology and General Surgery

Background:

• Plantar hyperhidrosis, characterized by excessive sweating of the feet, can significantly impact quality of life.
• Retroperitoneoscopic lumbar sympathectomy is an established treatment for this condition.
• Evaluating novel surgical approaches is crucial for improving patient outcomes.

Observation:

• A 27-year-old male patient with severe plantar hyperhidrosis underwent bilateral laparoendoscopic single-site retroperitoneal lumbar sympathectomy.
• A custom single port was utilized through a small incision, facilitating the use of standard laparoscopic instruments.
• The retroperitoneal approach allowed for targeted sympathectomy of the lumbar sympathetic chain.

Findings:

• The procedure was successfully completed bilaterally with no intraoperative or postoperative complications.
• Minimal blood loss and uneventful recovery were noted.
• The patient achieved complete resolution of foot sweating (anhidrosis) with a Hyperhidrosis Disease Severity Scale score of 1 at one month post-surgery.

Implications:

• Laparoendoscopic single-site retroperitoneal lumbar sympathectomy presents a safe and feasible minimally invasive option for managing plantar hyperhidrosis.
• This technique may offer advantages in terms of reduced invasiveness and potentially faster recovery compared to traditional methods.
• Further studies with larger cohorts are warranted to confirm the long-term efficacy and broader applicability of this approach.